I second Melanie’s advice regarding talking to legal and compliance. What you are doing sounds very similar to what we do at our institution, however we (internal occupational
health) are also responsible for our medical school’s employee health (they pay us a retainer and then per click for services used). We do manage their students, faculty, staff, and housestaff, as well as our diagnostic laboratory employees (we are part owners
of that business).
Any students not affiliated with our medical school, temporary workers or visitors are referred to Urgent Care and the ED. After hours, external clients (first responders, care
center employees, dental clinic workers, etc) would also use Urgent Care or the ED for services. Our external occupational health clinics then see those patients for followup care. Good Samaritans would see their PCP/urgent care/ED, depending on the timing.
There really is no way for urgent care and ED’s to remove themselves from significant exposure management. What we have done instead is start a process improvement project to
provide them with more tools in EPIC to simplify the process for their providers.
Laura L Radke, MD
Adjunct Assistant Professor of Medicine
Senior Medical Director, F&MCW Occupational Health Services
Phone: 262-253-8197 | Fax: 262-253-5152 Cell Phone: 414-530-0723
E-mail:
laura.radke@froedtert.com
Froedtert & the Medical College of Wisconsin Workforce Health / North Hills Health Center
Building B First Floor
W129 N7055 Northfield Dr.
Menomonee Falls, WI 53051
From: MCOH-EH <mcoh-eh-bounces@mylist.net>
On Behalf Of Swift, Melanie D., M.D., M.P.H. via MCOH-EH
Sent: Saturday, August 3, 2024 10:04 AM
To: MCOH-EH <mcoh-eh@mylist.net>
Cc: Swift, Melanie D., M.D., M.P.H. <Swift.Melanie@mayo.edu>
Subject: Re: [MCOH-EH] evaluation of employees and non-employees with BBP exposures
|
Hi Patrick,I am assuming that your employee health clinic is different from the occupational health clinic that sees external worker's comp - is that right? Is the
ED asking employee health to provide after hours care for patients who will follow up in occupational health?You may |
Hi Patrick,
I am assuming that your employee health clinic is different from the occupational health clinic that sees external worker's comp - is that right? Is the ED asking employee health to provide after hours care for patients who will follow
up in occupational health?
You may want to start by talking with your in house legal counsel and establishing a clear scope of patients your employee health clinic can legally serve. This varies among institutions depending upon how you are situated and funded. Many
internal employee health services are funded by the institution and do not charge for care provided to employees, in which case the funding source is unlikely to authorize that budget to be used for non-employees, especially if they are not affiliated with
your institution. At least the ED has a mechanism to bill private insurance or workers comp.
A rhetorical question: how does the ED plan to "get out of the BBP exposure business" for sexual assaults and other nonoccupational exposures, like injuries sustained in a fight with mucosal exposure
to the assailant's blood? They obviously need to retain protocols and competency to manage those exposures, so what's the concern with managing occupational exposures? It sounds like they are able to hand off the worker's comp and OSHA requirements
to partners in the institute next day.
Melanie
From: MCOH-EH <mcoh-eh-bounces+swift.melanie=mayo.edu@mylist.net>
on behalf of Hartley, Patrick G via MCOH-EH <mcoh-eh@mylist.net>
Sent: Wednesday, July 31, 2024 7:33:29 PM
To: mcoh-eh@mylist.net <mcoh-eh@mylist.net>
Cc: Hartley, Patrick G <patrick-hartley@uiowa.edu>
Subject: [EXTERNAL] [MCOH-EH] evaluation of employees and non-employees with BBP exposures
Colleagues,
I’m trying to ascertain, in your respective institutions, where you direct non-employees with potential blood borne pathogen exposures for evaluation and care (including PEP, if indicated).
Our ED colleagues would like to “get out of the business” of seeing BBP exposures, and would prefer these exposures (irrespective of employment status) to be managed by our employee health clinic, to which we are pushing back, and trying
to explore other options.
What we currently do at UIOWA is:
I’d appreciate any feedback regarding your processes. I’m sure other institutions have also struggled with how to manage employees vs. non-employees who may be exposed while caring for our patients but, due to work comp and other considerations,
may have different (and potentially less timely) assessment and care following BBP exposures.
Pat
Patrick G. Hartley, M.B., B.Ch., B.A.O., M.P.H.
Medical Director: University Employee Health Clinic
University of Iowa Carver College of Medicine
patrick-hartley@uiowa.edu
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